Update about “minimally verbal” children with autism spectrum disorder

ABSTRACT Objective: To review clinical and neurobiological features of minimally verbal children with autism spectrum disorder. Data source: We carried out a narrative review using the PubMed database. We considered the following search terms combined through the Boolean operator “AND”: “autism spectrum disorder”; “minimally verbal.” Data synthesis: To date, there is no shared definition of minimally verbal children with autism spectrum disorder. The heterogeneity in intellectual functioning and in linguistic abilities among these individuals suggests there is no single mechanism underlying their difficulties in learning to speak. However, the reasons why these children do not speak and the biological markers that can identify them are still unknown. Language impairment in these children can lead to several unfavorable consequences, including behavior problems (such as self-aggression, hetero-aggression, and property destruction), poorer daily living and social skills. Psychiatric comorbidities (including attention deficit/hyperactivity disorder, specific phobias, and compulsions) consist in a serious problem related to the lack of verbal language in individuals with autism spectrum disorder. Although in the literature there are very few evidence-based results, several findings suggest that an alternative and augmentative communication intervention, creating an extra-verbal communication channel, may be effective in these individuals. Conclusions: The exact definition, clinical characteristics, associated disorders, etiology, and treatment of minimally verbal subjects with autism spectrum disorder must still be further studied and understood.

Imitation Recognition by Minimally Verbal Young Children: A Comparison Between Down Syndrome and Autism Spectrum Disorder

Research has shown that children with autism spectrum disorder (ASD) display limited imitation recognition behaviors in comparison with typically developing children. However, the levels of imitation recognition of minimally verbal children with ASD relative to those with developmental disabilities are unknown. The purpose of this study was to compare the imitation recognition behaviors of 20 minimally verbal children with ASD and 20 minimally verbal children with Down syndrome (DS) when imitated by an adult in a play context. Results showed that children with ASD display more limited imitation recognition than children with DS. These results indicate that children with ASD are weaker in displaying imitation recognition. On the contrary, both groups display an association between imitation recognition and a variety of play actions in both groups.

How do minimally verbal children and adolescents with autism spectrum disorder use communicative gestures to complement their spoken language abilities?

Background and aims Prior work has examined how children and adolescents with autism spectrum disorder who are minimally verbal use their spoken language abilities during interactions with others. However, social communication includes other aspects beyond speech. To our knowledge, no studies have examined how minimally verbal children and adolescents with autism spectrum disorder are using their gestural communication during social interactions. Such work can provide important insights into how gestures may complement their spoken language abilities. Methods Fifty minimally verbal children and adolescents with autism spectrum disorder participated ( Mage = 12.41 years; 38 males). Gestural communication was coded from the Autism Diagnostic Observation Schedule. Children ( n = 25) and adolescents ( n = 25) were compared on their production of gestures, gesture–speech combinations, and communicative functions. Communicative functions were also assessed by the type of communication modality: gesture, speech, and gesture–speech to examine the range of communicative functions across different modalities of communication. To explore the role gestures may play the relation between speech utterances and gestural production was investigated. Results Analyses revealed that (1) minimally verbal children and adolescents with autism spectrum disorder did not differ in their total number of gestures. The most frequently produced gesture across children and adolescents was a reach gesture, followed by a point gesture (deictic gesture), and then conventional gestures. However, adolescents produced more gesture–speech combinations (reinforcing gesture-speech combinations) and displayed a wider range of communicative functions. (2) Overlap was found in the types of communicative functions expressed across different communication modalities. However, requests were conveyed via gesture more frequently compared to speech or gesture–speech. In contrast, dis/agree/acknowledging and responding to a question posed by the conversational partner was expressed more frequently via speech compared to gesture or gesture–speech. (3) The total number of gestures was negatively associated with total speech utterances after controlling for chronological age, receptive communication ability, and nonverbal IQ. Conclusions Adolescents may be employing different communication strategies to maintain the conversational exchange and to further clarify the message they want to convey to the conversational partner. Although overlap occurred in communicative functions across gesture, speech, and gesture–speech, nuanced differences emerged in how often they were expressed across different modalities of communication. Given their speech production abilities, gestures may play a compensatory role for some individuals with autism spectrum disorder who are minimally verbal. Implications Findings underscore the importance of assessing multiple modalities of communication to provide a fuller picture of their social communication abilities. Our results identified specific communicative strengths and areas for growth that can be targeted and expanded upon within gesture and speech to optimize social communication development.

Characterizing the early vocabulary profiles of preverbal and minimally verbal children with autism spectrum disorder

Children with autism spectrum disorder often have significant language delays. But do they learn language differently than neurotypical toddlers? We compared the lexical skills of 64 preverbal and minimally verbal children with autism spectrum disorder to 461 vocabulary-size-matched typically developing toddlers. We also examined social features of verb knowledge using a novel collection of social ratings. Children with autism spectrum disorder produced proportionally more verbs than typically developing toddlers. Children with autism spectrum disorder produced proportionally more action and food words, while typically developing toddlers produced proportionally more animal, people words, and animal sounds and sound effects. Children with autism spectrum disorder also produced “mommy” and “daddy” at lower rates. We discuss how these differences may reflect an association between lexical development and weaknesses in social communication. Lay abstract Although preverbal and minimally verbal children with autism spectrum disorder represent a significant portion of the autism spectrum disorder population, we have a limited understanding of and characterization of them. Although it is a given that their lexical profiles contain fewer words, it is important to determine whether (a) the words preverbal and minimally verbal children with autism spectrum disorder produce are similar to the first words typically developing children produce or (b) there are unique features of the limited words that preverbal and minimally verbal children with autism spectrum disorder produce. The current study compared the early word profiles of preverbal and minimally verbal children with autism spectrum disorder to vocabulary-matched typically developing toddlers. Children with autism spectrum disorder produced proportionally more verbs than typically developing toddlers. Also, children with autism spectrum disorder produced proportionally more action and food words, while typically developing toddlers produced proportionally more animal words, animal sounds and sound effects, and people words. Children with autism spectrum disorder also produced “mommy” and “daddy” at lower rates. Our findings identified several areas of overlap in early word learning; however, our findings also point to differences that may be connected to core weaknesses in social communication (i.e. people words). The findings highlight words and categories that could serve as useful targets for communication intervention with preverbal and minimally verbal children with autism spectrum disorder.

Examining Useful Spoken Language in a Minimally Verbal Child With Autism Spectrum Disorder: A Descriptive Clinical Single-Case Study

Purpose This was a companion study to a previous one (Biller & Johnson, 2019). The purpose was to develop a detailed descriptive profile of a minimally verbal child with a unique medical history and autism spectrum disorder (ASD). The present report describes his social-cognitive and speech sound production abilities in relation to his potentially burgeoning spoken language. Method This in-depth, descriptive, clinical single-case study focused on a 3-year-old boy who was diagnosed with a chromosomal abnormality and ASD. The size of his spoken vocabulary fell at the upper limit for classifying a child as minimally verbal. His demographic information was obtained, in addition to general information from his mother. Four social-cognitive and three speech sound production abilities were assessed, as well as his overall performance in both domains. The study included a parent interview and two child assessment sessions. Results The child exhibited low social-cognitive and speech sound production abilities for his age, with social-cognitive abilities higher than speech sound production abilities. Comparison with the previous study revealed substantial gaps in social cognition and speech sound production between this child and five other minimally verbal children with ASD. His higher abilities in these two domains co-occurred with his larger spoken vocabulary size. Conclusions Although the child's social-cognitive abilities were low for his age, with his speech sound production abilities even lower, both domains were perhaps high enough to support spoken vocabulary at the upper limit for minimally verbal children. Indeed, there appeared to be quantitative and qualitative differences between him and other minimally verbal children in the previous study. The possibility was explored that there is a point or threshold along the developmental continua for social cognition and speech sound production that allows for expansion into useful language.